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The Panel was informed that amendments to the Minutes of the Meeting held on 15 June 2015 had been received after publication of the Agenda. In particular, it was highlighted that Ms. Walker, Surrey County Council’s Public Health Lead, wished it to be recorded that while it was difficult to determine the exact causes, there was some evidence to suggest that increased risk drinking (more than 3-4 units a day on a regular basis) was more prevalent in affluent communities and that deaths from liver disease were currently being analysed. It was also noted that the summary of the structure of the various Surrey Public Health units and teams had been clarified.
The Minutes would be duly amended and re-circulated. The Panel agreed that the Chairman accordingly be authorised to sign the Minutes, as amended, as a true record of the said meeting.
Declarations of Interest
No declarations of interest were made by councillors regarding items on the agenda.
Surrey Downs Clinical Commissioning Group
The Chairman welcomed James Blythe, Director of Commissioning and Strategy to the meeting. Mr. Blythe was attending the meeting to provide an update on the work of the CCG on behalf of Karen Parsons, Chief Operating Officer, who was unable to attend.
Community Hospital Services Review
There had been a number of changes over recent years at all of the five community hospital sites. The current challenge facing the CCG was around the appropriate service model and the sustainability of services in the longer term.
The CCG had a contract for in-bed services at four of the sites: Molesey, Leatherhead, Epsom and Dorking. Beds had been moved to Dorking from Leatherhead to ensure safe levels of staffing.
A review of the service had commenced in March this year. It involved observation work in each hospital by an experienced clinician, a review of activity and outcomes and what other models were used around the country. At the start of the review process a Programme Board had been convened to oversee the review process. The Community Hospital Review Programme Board was chaired by Dr Jill Evans and included two members of Surrey County Council’s Well-being and Health Scrutiny Board, County Councillor Tim Hall and Mole Valley District councillor Lucy Botting.
A draft review report had been published in August. In particular, Mr. Blythe highlighted that the draft report considered how the rehabilitation service should be run and set out a number of options for the future configuration of in-patient beds. In summary, the general recommendation was that beds were sustainable on three sites and the options for their configuration (which would be the subject of further consultation) were:
· In-patient services to be retained at Epsom, Moseley and Dorking
· In patient services at Moseley to be moved to Cobham (built in the 1990s, this facility had accommodated in-patient beds in the past and there was likely to be demand for facilities in that locality in the future)
· In-patient services at Epsom to stay at their current site or be co-located on the Epsom Hospital site (this had been piloted last year when the current site had been under refurbishment and was linked with the Hospital’s estates review). If some beds from West Park were relocated then consideration would be given to the services left on the site. If all beds were relocated then the site would be potentially vacant and available for redevelopment but the future of the site would be a decision for NHS property services.
· In-patient services at Epsom and Moseley to be moved as stated above.
Each option included the retention of Dorking because of its service catchment area, particularly south of Dorking, and its out-patient services. None of the options included beds being re-instated at Leatherhead and the in-patient ward would be closed permanently. The future of the Leatherhead site lay in the development of the site for out-patient service delivery as a planned care hub. This was because of the excessive costs and unsuitability of the Leatherhead ... view the full minutes text for item 7.
Epsom & St. Helier University Hospitals Trust
Mr. Daniel Elkeles, Chief Executive, Epsom and St. Helier University Hospitals Trust, provided an update to the Panel on the Trust’s latest performance, financial position and its estates review.
The Panel was reminded that the Trust had five corporate objectives. Mr. Elkeles was pleased to report that the Trust had a lower infection rate than last year and that staff sickness was also low (3.52% as at end of July against a target of < 3.65%).
In terms of creating a positive patient experience, recommendation rates from the patient Friends and Family Test (FTT) continued to score between 93% and 97% and staff FFT (% of staff who would recommend the Trust’s hospitals as a place of work and as a place to receive treatment) indicated that staff would want to be treated there.
In respect of providing responsive care, the Trust was the second highest performing Trust in London with 96.5% of patients spending less than 4 hours in A&E. The 62 day cancer standard had been challenging and was still not being met. However, the Trust was doing everything it could to treat patients as quickly as possible. The Trust was investing in additional CT and endoscopy capacity, changing pathways to enable investigative procedures to be carried out more quickly and was working with GP partners to ensure plans were in place for increases in demand.
The Trust’s financial position was very challenging with a £7.6m deficit as at the end of July. A financial recovery plan had been developed which focussed on three areas: in particular, continuing to reduce the Trust’s reliance on agency staff in both nursing and medical posts. Mr. Elkeles was pleased to report that, having started the year with 550 clinical vacancies, by the end of July this had been reduced to 90 posts and there were almost 100 new starters due to take up their posts by the end of September. The Trust had filled all its midwifery posts and all current clinical posts were full. This would significantly reduce the pay bill.
The Trust also continued to work in partnership. In particular, Mr. Elkeles highlighted the exemplary work around care of the elderly which ought to make a real difference.
Mr. Elkeles also wished to highlight the annual Volunteers Tea Party which took place last week at Epsom Racecourse and which he had the privilege of presenting long standing service awards. Volunteers provided much valued support to the hospitals, patients and visitors and provided over 78,000 hours of their time per year.
Finally, the Panel was informed that work was also well underway to prepare for the Care Quality Commission Inspection of the hospitals commencing on 10 November 2015.
In regard to the estates review, Mr. Elkeles reiterated the commitment to retaining consultant led, 24/7 A&E, maternity and inpatient paediatric services at both Epsom and St. Helier hospitals over the next five years but that the focus for Epsom would be on the provision of planned care. However, in ... view the full minutes text for item 8.